Every postpartum patient with a hypertensive diagnosis (gestational HTN, mild pre-eclampsia, severe pre-eclampsia, or chronic HTN) needs structured outpatient follow-up. Two pathways depending on the patient's language:
- •English-speaking → enroll in the MyChart Gestational Hypertension plan from the discharge navigator.
- •Non-English-speaking (Spanish or any other language) → schedule a 3-day post-discharge visit (virtual, telephone, or in-person).
English-speaking patients — MyChart Gestational Hypertension Plan
Placed from the discharge navigator. Requires the patient to have MyChart set up with the app downloaded on their phone (so they get reminders to log their blood pressures).
- •Open the discharge navigator → place the MyChart Gestational Hypertension plan order. You don't need to change any of the buttons on the first screen — just hit Accept.
- •On the next screen, select where the patient is following up (which clinic will monitor the submitted BPs and call the patient if they never submit anything). See the clinic-assignment table below.
- •On the screen after Accept, associate the MyChart plan with a hypertension diagnosis on the problem list. If it isn't already there, search for it (gestational HTN, mild pre-eclampsia, severe pre-eclampsia, or chronic HTN) and add it.
[Screenshot placeholder: discharge navigator — MyChart Gestational Hypertension plan order, initial screen — accept as-is]
[Screenshot placeholder: clinic-assignment dropdown for follow-up]
Follow-up clinic by hospital + insurance:
| Hospital | Patient | Follow-up clinic |
|---|---|---|
| DUH | DWHA patient | DWHA |
| DUH | Any other patient (including health department) | Durham Perinatal |
| DRH | Delivered by Harris & Smith | Harris & Smith |
| DRH | Delivered by Durham OB | Durham OB |
| DRH | Health department patient | Whichever clinic delivered them (Harris & Smith or Durham OB) |
Non-English-speaking patients (Spanish or any other language)
These patients are NOT enrolled in the MyChart plan. Instead, schedule a virtual visit, telephone visit, or in-person visit ~3 days after discharge home. They still need a hypertensive diagnosis on the problem list.
- •In-person visit — reserve for patients with multiple complex issues or specific concerns for follow-up.
- •Telephone visit — confirm the patient has a good phone number and understands they will get a call.
- •Virtual visit — confirm they know how to log onto MyChart for the visit.
Scheduling — DUH
- •Monday–Friday: easiest is to tell the case manager what type of visit is needed at the 9:15 huddle.
- •Weekend: send an internal communication requesting the visit to either the DWHA or DUH clerical staff pools.
- •Patient follows up at DWHA or DUH depending on which clinic they're established with.
Scheduling — DRH
- •Send an internal communication to schedule the visit at Harris & Smith or Durham OB (based on who delivered the patient).
Blood pressure cuff — dispense from the floor if the patient doesn't have one at home
Place the order in the regular orders section (not the discharge navigator) so the nurses can dispense a cuff at discharge.
[Screenshot placeholder: order to dispense blood pressure cuff]
Patient instructions — attach in the discharge navigator
In the patient instructions section of the discharge navigator, attach the appropriate blood pressure information. This is what the nurses / virtual nurses review with the patient on discharge — if nothing is attached, they have nothing to review.
- •Standardized content is a work in progress. In the meantime, check with your upper levels for the current dot phrase.
- •Speed buttons make this faster — you can add your commonly-used dot phrases to the patient-instructions tab so they're one tap away.
[Screenshot placeholder: patient-instructions tab with dot-phrase speed buttons]
How to add your own speed buttons
- •Click the wrench icon in the top right corner of the patient-instructions tab.
- •In the Discharge instructions speed button middle box, type the name of the dot phrase you want to add.
- •Hit Accept at the bottom.
[Screenshot placeholder: wrench icon + speed-button configuration modal]